• Title/Summary/Keyword: Korean Foot and Ankle Surgery

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Current Trends in the Treatment of Osteochondral Lesion of the Talus: Analysis of the Korean Foot and Ankle Society (KFAS) Member Survey (거골 골연골병변 치료 동향: 대한족부족관절학회 회원 설문조사 분석)

  • Cho, Byung-Ki;Cho, Jaeho;Young, Ki Won;Lee, Dong Yeon;Bae, Su-Young;The Academic Committee of Korean Foot and Ankle Society,
    • Journal of Korean Foot and Ankle Society
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    • v.25 no.4
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    • pp.149-156
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    • 2021
  • Purpose: Given the lack of definite evidence-based guidelines in clinical practice, there may be a wide variation in treatment protocols for osteochondral lesions of the talus (OLT). Based on the Korean Foot and Ankle Society (KFAS) member survey, this study aimed to report the current trends in the management of OLT. Materials and Methods: A web-based questionnaire containing 30 questions was sent to all KFAS members in September 2021. The questions were mainly related to clinical experience and preferences in diagnosis, conservative, and surgical treatments for patients with OLT. Answers with a prevalence of ≥50% of respondents were considered a tendency. Results: Sixty-two (11.3%) of the 550 surgeons queried responded to the survey. The responses to 9 (30.0%) of the total of 30 questions established a tendency. Answers exhibiting a tendency were as follows; additional diagnostic tools except for plain radiograph (magnetic resonance imaging), most common conservative treatment method (oral medication, rest), most important radiological factor in decision making for surgical treatment and method (size of the lesion, ankle instability, loose bodies), most important patient factors in decision making for surgical treatment and method (age, activity or occupation), infrequently requiring posterior arthroscopy (less than 3%), most common revision surgery for failed bone marrow stimulation procedure (osteochondral autograft transplantation [OAT]), not requiring additional procedure for donor site in OAT, the main reason for unsatisfactory result after OAT (persistent pain without radiological abnormality), no generalization of autologous chondrocyte implantation or chondrogenesis using stem cells. Conclusion: This study presents updated information on current trends in the management of OLT in Korea. Both consensus and variations in the approach to patients with OLT were revealed through this survey. Since recent biologic efforts to regenerate cartilage have been unsuccessful, further studies to identify clinical evidence would be needed.

Achilles Tendon Rupture Associated With Ipsilateral Medial Malleolar Fracture (A Case Report) (아킬레스 건 파열과 동반된 동측 족관절 내과 골절(1예 보고))

  • Chae, Soo-Uk;Yang, Jung-Hwan
    • Journal of Korean Foot and Ankle Society
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    • v.15 no.1
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    • pp.36-38
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    • 2011
  • Ankle fracture and Achilles tendon rupture are common as an isolated injury. However, Achilles tendon rupture with ipsilateral ankle fracture is uncommon, and occurs by a different injury mechanism with a risk of negligence. We report a case of Achilles tendon rupture with ipsilateral medial malleolar fracture.

Recurred Diffuse Pigmented Villonodular Synovitis of Ankle Joint - Case Report - (재발한 족관절의 미만성 색소 융모 결절성 활액막염)

  • Kim, Hak-Jun;Kim, Taik-Seon;Suh, Dong-Hun;Yoon, Kwang-Sup;Chung, Kuuk-Jin;Jeon, Seung-Ju
    • Journal of Korean Foot and Ankle Society
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    • v.9 no.2
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    • pp.220-223
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    • 2005
  • Pigmented villonodular synovitis (PVNS) in ankle is relatively uncommon. This disorder results in increased proliferation of synovium causing villous or nodular changes containing histiocytes, fibroblasts, multinucleated giant cell, and hemosiderin. PVNS is classified into two different type : localized and diffuse. Diffuse type of PVNS in ankle is more common than localized type. Also, recurrence of diffuse type is more frequent. We report a case of diffuse type of PVNS which was recurred soon after the excision.

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Anterior Compartment Syndrome after Surgery of Bosworth Fracture-Dislocation of the Ankle - A Case Report - (족관절의 Bosworth 골절-탈구 발생한 전방 구획 증후군 -증례 보고-)

  • Chung, Hyung-Jin;Park, Se-Jin;Choi, Yun-Seok
    • Journal of Korean Foot and Ankle Society
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    • v.8 no.2
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    • pp.221-223
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    • 2004
  • Bosworth fracture-dislocation of ankle is very rare, occurred by eversion and external rotation force. It is known as irreducible fracture by closed method. Also, compartment syndrome after ankle fracture are exceedingly rare. There are only a few reported cases of compartment syndrome after ankle fracture and compartment syndrome are involved commonly deep posterior compartment. We present a case in which a patient had a Bosworth fracturedislocation of the ankle underwent open reduction with internal fixation and subsequently occurred an anterior compartment syndrome of the leg.

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Upside-down Adipofascial Flap for the Medial Foot Soft Tissue Defect after Trauma: Case Report (지방 근막 피판을 이용한 외상성 족부 내측면의 연부 조직 결손의 치료: 증례보고)

  • Kim, Min Bom;Lee, Young Ho;Seo, Gil Joon;Baek, Goo Hyun
    • Journal of Trauma and Injury
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    • v.28 no.1
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    • pp.27-30
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    • 2015
  • A child sustained a car tire friction injury and had multiple soft tissue wounds. She had a severe soft tissue defect in the medial foot and ankle aspect which requiring flap coverage. We performed an adipoafscial flap with upside-down pattern for the treatment of the medial foot and ankle soft tissue posttraumatic defect. The flap is based on the perforator artery from the posterior tibial artery. Because it gave a thin coverage for the foot, the patient could walk with normal foot wear.

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Meshed Stab Incision for Severe Swelling after Foot and Ankle Injury: A Technical Report (족부 및 족관절 손상 후 심한 부종에 대한 그물망 절개술: 술기 보고)

  • Hyun, Yoon-Suk;Kim, Gab-Lae;Shin, Sung-Il;Hong, Sung-Yup;Park, Jung-Seob;Choi, Sang-Min
    • Journal of Korean Foot and Ankle Society
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    • v.19 no.1
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    • pp.39-41
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    • 2015
  • Swelling is a body's natural reaction to foot and ankle injury to mount a healing inflammatory response. To some degree, swelling is necessary for healing and is something that cannot be avoided following injury. However, post-traumatic swelling may have an adverse effect on wound healing and surgery can often be delayed due to preoperative swelling. We report on a unique technique of making multiple meshed stab incisions around the site of injury to reduce soft tissue swelling and promote wound healing.

Outcomes of Lateral Malleolar Saving versus Sacrificing Procedure in Transfibular Ankle Arthrodesis (경비골 도달법을 이용한 족관절 유합술 시 외과의 보존과 희생 방법의 차이에 따른 결과)

  • Chung, Hyung-Jin;Bae, Su-Young;Shin, Yong-Woon;Lim, Dong-Ju;Cho, Sung-Il
    • Journal of Korean Foot and Ankle Society
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    • v.14 no.2
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    • pp.135-139
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    • 2010
  • Purpose: We analyse and report the result of transfibular ankle arthrodesis using lateral malleolar saving procedureversus lateral malleolar sacrificing procedure. Materials and Methods: Eighteen cases of transfibular ankle arthrodesis which were performed since 2001 were included. We devided them into lateral malleolar saving and lateral malleolar sacrificing groups. We reattached and fixed lateral malleolus in 10 cases and sacrificed malleolus for morcelized bone graft in 8 cases. We evaluated clinical results by AOFAS ankle-hindfoot score, visual analogue scale (VAS) and radiological results by union time. Complications and subjective satisfaction degrees were also recorded and compared between two groups. Results: Preoperative mean AOFAS score was 32 points (16~41) and VAS was 7.5 points (7~8) and they were changed into 68.6 points (61~77) and 2.8 points (2~4) postoperatively. There was no significant difference in clinical results between the two groups even though lateral malleolar saving group showed higher AOFAS score (69.4) than lateral malleolar sacrificing group (67.7). Duration of getting union was 11.3 weeks in lateral malleolar saving group and 10.6 weeks in lateral malleolar sacrificing group. There was no difference in subjective satisfaction level. There were one delayed union and one nonunion in lateral malleolar sacrificing group and one nonunion in lateral malleolar saving group. Conclusion: There was no difference in clinical and radiological results between lateral malleolar saving group and lateral malleolar sacrificing group of transfibular ankle arthrodesis. Therefore it may not necessary to sacrifice lateral malleolus for bone graft except very selective case for which heavy graft is needed.

Treatment of Metatarsalgia after a Surgery (수술 후 중족골통의 치료)

  • Chun, Dong-il
    • Journal of Korean Foot and Ankle Society
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    • v.24 no.1
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    • pp.9-13
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    • 2020
  • Metatarsalgia is a generalized term used to describe forefoot pain. The possible etiologies can range from direct to indirect pathologies. Metatarsalgia has several causes. This paper evaluates the recent literature to provide an in-depth review of metatarsalgia after forefoot surgery.

Skin Graft Remains a Clinically Good Treatment Strategy for Chronic Diabetic Wounds of the Foot and Ankle (피부이식술을 통한 만성 당뇨족 창상 치료의 효용성)

  • Kim, Yoon-Chung;Kim, Bo-Seoung;Jeong, Howon;Ahn, Jae Hoon
    • Journal of Korean Foot and Ankle Society
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    • v.26 no.2
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    • pp.78-83
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    • 2022
  • Purpose: The purpose of this study was to evaluate the surgical outcome of split-thickness skin graft (STSG) for chronic diabetic wounds of the foot and ankle. Materials and Methods: The medical records of 20 patients who underwent surgery for chronic diabetic wounds of the foot and ankle between October 2013 and May 2018 were reviewed. Surgical management consisted of consecutive debridement, followed by negative-pressure wound therapy and STSG. We used an acellular dermal matrix between the wound and the overlying STSG in some patients with wide or uneven wounds. Patient satisfaction, comorbidities, wound size and location, length of hospital stay, wound healing time, and complications were investigated. Results: Of 20 patients, 17 (85.0%) were satisfied with the surgical outcome. Eight patients had diabetic wounds associated with peripheral vascular disease (PVD), 7 patients had diabetic wounds without PVD, and 5 patients had acute infection superimposed with necrotizing abscesses. The mean size of the wound was 49.6 cm2. The mean length of hospital stay was 33.3 days. The mean time to wound healing was 7.9 weeks. The mean follow-up period was 25.9 months. Complications included delayed wound healing (4 cases) and recurrence of the diabetic wounds (2 cases), which were resolved by meticulous wound dressing. Conclusion: STSG remains a good treatment strategy for chronic diabetic wounds of the foot and ankle.

Ankle Arthrodesis Using Auto Fibula Bone Graft: Two Cases Report (자가 비골이식술을 이용한 족관절 유합술: 2예 보고)

  • Yi, Chang-Ho;Yoon, Won-Sik;Oh, Jin-Rok
    • Journal of Korean Foot and Ankle Society
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    • v.15 no.2
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    • pp.102-106
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    • 2011
  • Recently, development and improvement in joint replacement therapy, the need for arthrodesis has been decreasing. However, result of joint replacement is not always satisfactory, and most cases are rather indicative to ankle arthrodesis than ankle replacement. Often, ankle arthrodesis can be more beneficial salvage method to treat cases with failure in joint replacement therapy, talar avascular necrosis with massive bone defect, talus fracture with severe comminution and bone defect and ankle dislocation. In cases with large bone defect that need to be treated with ankle arthrodesis using internal fixation, it is difficult to fill the defect with conventional auto-iliac bone or all-bone graft. Thus, we make a report on our experience in treating 2 cases with ankle arthrodesis using auto-fibular bone graft and plate fixation.